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Organization

GOOD SAMARITAN NURSING HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LINDA D COOK RN ADMINISTRATOR (ADMINISTRATOR)
(309) 289-2614
Entity
Organization

Contact information

Practice address
407 N HEBARD STREET, KNOXVILLE, IL 61448
(309) 289-2614
(309) 289-8847
Mailing address
407 N HEBARD STREET, KNOXVILLE, IL 61448
(309) 289-2614
(309) 289-8847

Taxonomy

Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0001107
IL
Enumeration date
07/21/2006
Last updated
08/22/2020
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